Mifepristone/ Misoprostol

Mifepristone is taken orally and blocks the action of progesterone. This results in:

1. Uteral lining thinning
2. Pregnancy detachment
3. Cervical softening and dilation
4. Uterine contractions

Subsequent administration of oral or vaginal misoprostol, a prostaglandin E analogue, results in uterine contractions and expulsion of the products of conception.

• High success rate (95%)
• Available during early pregnancy
• Resembles a "natural miscarriage"
• Often considered to be more "private"
• Usually avoids surgical intervention
• Anesthesia not usually required

• Requires two clinic visits
• Takes days, sometimes weeks, to complete
• Efficacy decreases at later gestational ages
• Post-procedure bleeding may last for weeks
• Women may see blood clots and the products of conception
• Mifepristone is not available in most countries
• Mifepristone can be expensive

Methotrexate/
Misoprostol

Methotrexate is anti-metabolite that inhibits DNA synthesis. Given by injection or taken orally, methotrexate interferes with the implantation process.

Subsequent administration of oral or vaginal misoprostol, a prostaglandin E analogue, results in uterine contractions and expulsion of the products of conception.

• High success rate (95%)
• Used during early pregnancy
• Resembles a "natural miscarriage"
• Often considered to be more "private"
• Usually avoids aspiration intervention
• Anesthesia not usually required
• Treats ectopic pregnancy

• Requires at least two clinic visits
• Takes days to weeks to complete (longer than the mifepristone regimen)
• Post-procedure bleeding may last for weeks
• Efficacy decreases after 7 weeks gestation
• Women may see blood clots and the products of conception
• Methotrexate is not available in all countries

Misoprostol Only

Serial administration of oral or vaginal misoprostol, a prostaglandin E analogue, results in uterine contractions and expulsion of the products of conception.

• Used during early pregnancy
• Resembles a "natural miscarriage"
• Often considered to be more "private"
• Usually avoids aspiration intervention
• Anesthesia not usually required
• More accessible and affordable than other medical abortion regimens, particularly in developing countries

• Success rate is relatively low (88%)
• Regimen is still currently under investigation
• Takes days to weeks to complete
• Post-procedure bleeding my last for weeks
• Women may see blood clots and the products of conception

Vacuum Aspiration
(Surgical Abortion)

A straw-like tube (a cannula), which is attached to a suction apparatus is inserted into the uterus through the open (dilated) cervix. The uterine contents are then emptied by suction.

• High success rate (99%)
• May requires only one clinic visit
• Procedure completed within minutes
• Sedation is available

• Involves an invasive procedure
• May not be available very early in pregnancy
• Often considered to be less "private"